Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Diet and ldl particle size

14,504 views

Published on

In this slide deck I describe the effects of low cabrohydrate diet and fat modification on LDL particle size and number.

Published in: Health & Medicine
  • Slim Down in Just 1 Minute? What if I told you, you've been lied to for nearly all of your life? CLICK HERE TO SEE THE TRUTH ▲▲▲ http://t.cn/A6PnIGtz
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • The Recovery Program has made some amazing changes in my life, that I would not have dreamed possible. I have a new-found knowledge on bulimia and have learned so much about myself, the disease and how to take my life back. The support and wisdom from my fellow recoverees is priceless. I’d just feel so alone prior to joining, so opening up to the people in your same shoes and listening to their precious stories and advice has given me this immense strength to recover. ●●● http://scamcb.com/bulimiarec/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • ATTENTION! If You or Someone You Love is Suffering from Diabetes, Then This Will Be the Most Important Message You Will Ever Read...  https://tinyurl.com/yx3etvck
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • HOT MILFS LOOKING FOR SEX! F.U.C.K A MILF NEAR YOU TONIGHT!  http://t.cn/AiuWKDWR
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • 21748 Women, 374,701lbs lost - This Changes EVERYTHING! ■■■ http://scamcb.com/poundinc/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Diet and ldl particle size

  1. 1. The effect of diet on LDL particle size and LDL particle number (LDL-P) [Updated April 2015] Registered dietitian, M.Sc, MBA Reijo Laatikainen www.twitter.com/pronutritionist 1
  2. 2. Effect of diet on LDL particle size is much more controversial than some low carbohydrate diet proponents claim Favouring carbohydrate restriction and/or higher SFA intake Dreon 1998 Krauss 2006 Kratz 2002 Egert 2011 Guay 2012 2 Favouring MUFA or PUFA Wilkinson 2005 Mangravite 2013 Damasceno 2013 (nuts) Hernández-Alonso 2015 (nuts)
  3. 3. 1. Diet lower in carbs seems to lead to increased LDL particle size. 3
  4. 4. High intake of SFA ↓ amount of smallest LDL particles, no effect in other particle groups (in the context of low-carb diet) Krauss RM, Blanche PJ, Rawlings RS, Fernstrom HS, Williams PT Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Am J Clin Nutr. 2006 May;83(5):1025-31;.
  5. 5. Main driver of smaller (=worse) LDL particles (=LDL pattern B) was higher carb intake, not SFA content Page 5 Krauss RM, Blanche PJ, Rawlings RS, Fernstrom HS, Williams PT Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Am J Clin Nutr. 2006 May;83(5):1025-31;. N= 178, Interventions, 3-4 weeks in weight stable situation
  6. 6. Carbohydrate restriction increased LDL-particle size vs low fat diet. In other words both fat quality and carbohydrate quantity changed. Page 6 Dreon DM, Fernstrom HA, Campos H, Blanche P, Williams PT, Krauss RM. Change in dietary saturated fat intake is correlated with change in mass of large low-density-lipoprotein particles in men. Am J Clin Nutr. 1998 May;67(5):828-36. “The results indicate significant associations of dietary saturated fat intake with plasma LDL- particle distributions. Change in dietary saturated fat was associated positively with mass of larger LDL particles and with peak LDL particle diameter and LDL flotation rate.” N=103, interventions 6 weeks
  7. 7. Very short feeding study: Diet higher in fat (37E%) increases LDL particle size and LDL-C vs low fat diet (25E%) Page 7 Guay V, Lamarche B, Charest A, Tremblay AJ, Couture P. Effect of short-term low- and high-fat diets on low-density lipoprotein particle size in normolipidemic subjects. Metabolism. 2012 Jan;61(1):76-83. “Compared with the low-fat diet, plasma cholesterol, LDL cholesterol, and high-density lipoprotein cholesterol were significantly increased … following the 3-day high-fat diet.The high-fat diet was also associated with a significant increase in LDL particle size (255.0 vs 255.9 Å;P = .01) and a significant decrease in the proportion of small LDL particle (<255.0 Å) (50.7% vs 44.6%, P = .01).” N=12, interventions , 3 days, crossover, nonobese healthy men with normal plasma lipid profile.
  8. 8. 2. When carbohydrate intake is rather high and comparable between the groups, effects of fatty acids are controversial. 8
  9. 9. Very high intake of PUFAs and lower intake of SFA increased particle size when carbohydrate intake was around 40%E Page 9 Wilkinson P, Leach C, Ah-Sing EE, Hussain N, Miller GJ, Millward DJ, Griffin BA. Influence of alpha-linolenic acid and fish-oil on markers of cardiovascular risk in subjects with an atherogenic lipoprotein phenotype. Atherosclerosis. 2005 Jul;181(1):115-24. ,, Sunflower + fish oil Sunflower + fish oil Fat intake increased in all groups by 4-5 E% (carb intake ↓ 2-3 E%) Fat intake increased in all groups by 4-5 E% (carb intake ↓ 2-3 E%) N=57
  10. 10. No difference in between low fat and high MUFA diet (Diet higher in fat but not a “real” low carb study) Page 10 Egert S, Kratz M, Kannenberg F, Fobker M, Wahrburg U. Effects of high-fat and low-fat diets rich in monounsaturated fatty acids on serum lipids, LDL size and indices of lipid peroxidation in healthy non-obese men and women when consumed under controlled conditions. Eur J Nutr. 2011 Feb;50(1):71-9 “In conclusion, a low-fat and a high-fat diet, both rich in MUFA, had similar effects on serum lipids and lipoproteins, LDL size and indices of lipid peroxidation in metabolically healthy, young and non-obese men and women.” N=25, interventions 4 weeks
  11. 11. High MUFA diet reduced slightly LDL particle size vs diet high in SFA (carbs at level of 40%E) Page 11 Egert S, Kratz M, Kannenberg F, Fobker M, Wahrburg U. Effects of high-fat and low-fat diets rich in monounsaturated fatty acids on serum lipids, LDL size and indices of lipid peroxidation in healthy non-obese men and women when consumed under controlled conditions. Eur J Nutr. 2011 Feb;50(1):71-9 “The MUFA-rich diets significantly decreased the size of the predominant LDL fraction.” N=25 *) Diet high in SFA diet lasted only 1 week
  12. 12. High MUFA/PUFA diet slightly reduced LDL particle size vs diet high in SFA (in the context of high-carb diet) Page 12 Kratz M1, Gülbahçe E, von Eckardstein A, Cullen P, Cignarella A, Assmann G, Wahrburg U. Dietary mono- and polyunsaturated fatty acids similarly affect LDL size in healthy men and women. J Nutr. 2002 Apr;132(4):715-8. . ”In conclusion, changing the quality of dietary fat from saturated to unsaturated fat slightly reduced the LDL peak particle diameter, with no significant difference between diets rich in MUFA, (n-6)-PUFA and (n-3)-PUFA” N=56, interventions 4 weeks
  13. 13. 3. When low carbohydrate diet is high in red meat, replacing saturated fat for MUFA increases LDL particle size 13
  14. 14. Low SFA, high MUFA diet reduced LDP-P and small dense LDL particles (low carb, high read meat context) Page 14 Mangravite LM, Chiu S, Wojnoonski K, Rawlings RS, Bergeron N, Krauss RM. Changes in atherogenic dyslipidemia induced by carbohydrate restriction in men are dependent on dietary protein source. J Nutr. 2011 Dec;141(12):2180-5. =LDL-P High SFA (3 weeks) Low SFA (3 weeks)
  15. 15. 4. High intake of trans fat seem to reduce LDL particle size 15
  16. 16. Margarine lowest in trans fat has quite similar effects as butter. High trans fat intake reduced LDL particle size Page 16 Mauger JF, Lichtenstein AH, Ausman LM, Jalbert SM, Jauhiainen M, Ehnholm C, Lamarche B. Effect of different forms of dietary hydrogenated fats on LDL particle size. Am J Clin Nutr. 2003 Sep;78(3):370-5. N=36, 5 weeks
  17. 17. The higher the TFA content of margarine, the more deleterious effect on LDL particle size Page 17 Mauger JF, Lichtenstein AH, Ausman LM, Jalbert SM, Jauhiainen M, Ehnholm C, Lamarche B. Effect of different forms of dietary hydrogenated fats on LDL particle size. Am J Clin Nutr. 2003 Sep;78(3):370-5. ” In conclusion, data from the present study support the concept that consumption of trans fatty acids has a deleterious effect on LDL particle size, thus further contributing to the overall effect of trans fatty acids on cardiovascular disease”
  18. 18. 5. Mediterranean diet supplemented with nuts increased LDL size and reduced LDL-P. Extra virgin oil did NOT have this favourable effect. . 18
  19. 19. Med diet enriched with nuts (high in PUFA and MUFA) improved LDL particle profile. Predimed subcohort Page 19 Damasceno NR e tal. Mediterranean diet supplemented with nuts reduces waist circumference and shifts lipoprotein subfractions to a less atherogenic pattern in subjects at high cardiovascular risk. Atherosclerosis. 2013 Oct;230(2):347-53. N=169, intervention 52 weeks Only long term study available
  20. 20. 6. Isolated effect of nuts 20
  21. 21. Increased consumption of pistachio nuts → decrease in small LDL particles (in the context of high-carb diet) Page 21 Hernández-Alonso P, Salas-Salvadó J, Baldrich-Mora M, Mallol R2, Correig X, Bulló M.. Effect of pistachio consumption on plasma lipoprotein subclasses in pre-diabetic subjects. Nutr Metab Cardiovasc Dis. 2015 Apr;25(4):396-402. ” Small low-density lipoprotein particles (sLDL-P) significantly decreased after pistachio consumption compared to the nut-free diet (P = 0.023)” N=55, 4-month cross over interventions, prediabetic subjects
  22. 22. Conclusion • Many studies are very short, typically 3-4 weeks • Replacing carbohydrates with fat seems to increase LDL particle size • There is conflicting and limited evidence on the effects of fatty acid classes (MUFA/PUFA vs SFA) on LDL particle size and LDL-P • Trans fat seems to decrease LDL particle size. Currently available margarines in most European countries are very low in trans fat • Mediterranean diet improved LDL particle size in Predimed study when enriched with nuts (high in MUFA and PUFA). Nuts may have beneficial effect on LDL particle size • Hard end point RCTs are needed to evaluate if changes LDL-particle size translate into real clinical benefits 22
  23. 23. What about apoB, non-HDL- cholesterol, LDL, HDL and HDL when going low carb? Visit my other slide deck http://www.slideshare.net/pronutritionist/repla cing-carbohydrate-with-different-fats-effects- in-apo-b-non-hdl-and-ldl 23
  24. 24. Wellcome aboard! http://twitter.com/pronutritionist http://www.facebook.com/pronutritionist http://www.pronutritionist.net Reijo Laatikainen, RD, MBA Images bought and licensed from BigStockPhoto. Snapshots from papers and sites referred to. Page 24

×